Individual
JACQUELINE MARY CAELWARTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2920 SUPERIOR AVE, SHEBOYGAN, WI 53081-1944
(920) 458-3791
Mailing address
903 WINFORD AVE, GREEN BAY, WI 54303-4026
(920) 562-5771
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
06/11/2018
Last updated
06/11/2018
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